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    Exam Review

    1. The nurse is caring for a patient experiencing a stroke understands the importance of establishing the onset of the stroke before administering a tissue plasminogen activator based on which recommendation
      A)The activator is recommended for transient ischemic attacks
      B)The activator is not recommended if the stroke in greater than 3 hours
      C)The activator is recommended for patients with increased ICP
      D)The activator is not recommended the stroke is less than 3 hours
    2. The nurse is caring for a patient who has undergone major abdominal surgery. 4 hours post op Urine output 45 ml BP 120/80 mmHg HR 90 beats/min Weight 97.5 kg 24 hrs post op urine output 20 ml/hr for past 2 hours BP 100/50 mm Hg HR 110 beats/m Weight 99 kg According to the 4 hours post-op assessment data and the 24 hour assessment data, the nurse understands that the weight change corresponds to an
      A)fluid retention of 1.5 liters
      B)fluid loss of 0.5 liters
      C)equal intake and output due to insensible
    3. The nurse caring for the critical care patient who is mildly stressed knows that which of the following are caloric requirements for their patient
      A)40 kcal/kg/day
      B)25 kcal/kg/day
      C)25-30 kcal/kg/day.
      D)30-35 kcal/kg/day
    4. The nurse is to calculate gtt/min to transfuse one unit 160 ml of platelets over one hour using blood tubing that has a drop factor of 15. How many gtt/min would you administer?
      A)25
      B)35
      C)40
      D)45
    Page 1 of 13

    Exam Review

    1. Which pathology may result in acute kidney injury (AKI) from a prerenal etiology?
      A)Obstruction of urine flow
      B)Reduced perfusion
      C)Damage to kidney tissue
      D)Chronic kidney disease
    2. A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take?
      A)infuse 1 unit of platelet
      B)Restrict daily fluid intake
      C)Admin hydrocortisone sodium
      D)Give oral spironolactone
    3. A stress ulcer is a chronic form of peptic ulcer. (True or False)
      True/False
    4. Name: David Ramirez Age: 29 years Gender: Male Mechanism of injury: High-speed MVA, front-end collision; unrestrained driver EMS reports that the patient was found unconscious, slumped over the steering wheel. Airbag deployed. Windshield starred. No obvious external bleeding. EMS noted: Initial GCS 9 (E2 V2 M5) Hypotension that briefly improved after fluid bolus Worsening level of consciousness en route One episode of projectile vomiting Pupils unequal (R 5 mm sluggish, L 3 mm reactive) During transport, the patient extended both arms and legs rigidly in response to painful stimulus. PAST MEDICAL HISTORY No chronic illnesses reported No previous neurological issues Prior appendectomy Occasional alcohol use (friends stated he had "two beers earlier") Medications None prescribed Midline shift of 7 mm Signs of brain herniation Cerebral edema C-Spine CТ No fracture noted, but swelling present The patient suddenly extends his arms and legs rigidly after painful stimulation. What does this indicate?
      A)Brainstem injury
      B)Cerebral hemispheric injury (decorticate
      C)Meningeal Imitation
      D)Alcohol intoxication
    Page 2 of 13

    Exam Review

    1. Is the dog:
      A
      Option A
      A)Lying
      B)Standing
      C)Sitting
      D)No idea
    2. What is the preferred diet for a patient with cirrhosis with increased ammonia levels?
      A)Increased protein diet
      B)Decreased sodium diet.
      C)Decreased protein diet
      D)Increased carbohydrate diet
    3. Which practice guideline should the nurse implement when caring for the patient receiving enteral feedings?
      A)gastric residual volumes of 500 ml should be of concern
      B)gastric residual volume is checked every 2 hours
      C)gastric residual volumes of 100 ml should be of concern.
      D)gastric residual volume is checked every 6 hours
    4. Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
      A)A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections
      B)A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning
      C)An 83-year-old long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza
      D)An 18-year-old college student with type 1 diabetes whit exercises excessively
    Page 3 of 13

    Exam Review

    1. An important nursing intervention for the patient with an arteriovenous fistula is to: Select all that apply)(SATA)
      A)auscultate for a bruit every 8 hours
      B)use the fistula for blood draws
      C)palpate for a bruit every 4 hours
      D)palpate for the presence of a thrill every 8 hours.
      E)obtain blood pressure in the extremity that has fistula
    2. A patient with acute kidney injury has the following labs: GFR 92mL/min BUN 17mg/dL potassium 4.9mEq/L creatinine 1mg/dL. The patient's 24 hour urinary output is 1.75 Liters, Based on these findings, what stage of AKI is this patient in?
      A)Recovery
      B)Oliguria
      C)Initiation
      D)Diuresis
    3. A 36-year-old male patient arrives at the trauma department after being involved in a motor vehicle accident. Due to a major vehicle pile-up on a flyover bridge. EMS arrival and intervention were delayed. The patient's vital signs on arrival are as follows: Heart rate: 130 bpm Blood pressure:80/50 mmHg Respiratory rate: 28 breaths per minute Oxygen saturation: 90% on 10/min via non-rebreather mask Temperature: 97.2°F (36.2°C) Skin: Cool, pale, and diaphoretic Based on the patients condition and prolonged time without intervention, what type of shock and what stage of shock might the patient be in? (Select all that apply)(SATA)
      A)Neurogenic
      B)Hypovolemic shock
      C)Cardiogenic shock
      D)Initial stage of shock
    4. Of the following for which patient would you suggest oral or enteral feedings?
      A)A patient who has been NPO for 36 hours
      B)A patient with a Gl obstruction
      C)A patient who is severely dehydrate
      D)A patient experiencing intractable vomiting
    Page 4 of 13

    Exam Review

    1. Which patient below with acute kidney injury is in the oliguric stage of AK?
      A)A 78 year old female with respiratory acidosis, increased GFR, decrease Bun/Creatinine, hypokalemia, and urinary output of 550mL/day
      B)A 30 year old male with metabolic acidos, hyperkalemia, improving GF resolving edema and urinary output of 4L/day
      C)A 56 year old male who has metabolic acidosis, decreased GFR, increased BUN/Creatinine, hyperkalemia, edema, and urinary output of 350mL/day
      D)A 45 year old female with metabolic acidosis, hypokalemia, normal GFR increased BUN/Creatine edema, and urinary output of 600mL/day
    2. The nurse assessing the patient with increased intracranial pressure (ICP) understands which factors are associated with increased ICP (Select all that apply)(SATA)
      A)increased bone tissue
      B)Increased cerebral blood volume
      C)increased systemic blood volume
      D)increased cerebrospinal fluid (CSF)
      E)increased brain volume
    3. An 82-year-old female patient arrives at the emergency department after a fall off of ladder while putting up her Christmas lights on the outside of her house. She states "I just misstepped on the ladder rung I won't dizzy or anything like that. She currently reports being very dizzy and reports some abdominal pain Vital signs include Heart rate: 115 bpm Blood pressure: 88/54 mm Respiratory rate: 22 breaths per minute Oxygen saturation 56% on room air Skin Cool and clammy What should the nurse watch for in this patient, and what is the first action? (Select all that apply(SATA)
      A)Monitor for signs of compensatory shock progressing to decompensated shock
      B)Administer pain medication for abdominal pain
      C)Assess for signs of internal or external blood loss
      D)Establish IV access with a large-bore catheter and prepare to administer fluids
      E)Position the patient in Trendelenburg position to improve blood flow to the brain
      F)Monitor for signs of dehydration
    4. A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?
      A)Strong bounding pulse
      B)Diminished deep tendon reflexes
      C)Tingling and numbness of the hands and feet
      D)Decreased bowel sounds
    Page 5 of 13

    Exam Review

    1. Some patients may have decreased appetite, difficulties in swallowing or some type of surgery that interferes with eating. When this happens, when one is unable to eat, nutrition must be supplied in a different way. What method can be utilized?
      A)Mechanical diet
      B)Soft food diet
      C)Pureed diet
      D)Enteral feeding
    2. A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings?
      A)Sunken eyes
      B)Tremors
      C)Lethargy
      D)Cold intolerance
    3. A 55-year-old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury?
      A)Post-renal
      B)Intra-real
      C)Pre-renal
      D)Intrinsic renal
    4. A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA?
      A)Weight gain of 0.45 kg (110 in 24 hours)
      B)Rapid, shallow respirations
      C)Decreased urine output
      D)Blood glucose levels 300 mg/dL
    Page 6 of 13